血管介入栓塞胶同轴注射过程中血流动力学与聚合反应联合作用对胶滴生成的影响

The coupling effect of hemodynamics and embolic glue polymerization plays an important role during the coaxial injection in endovascular embolization for the management of arteriovenous malformations, in which the control of droplet formation process directly determines the embolization results. Recently, the coaxial injection process of embolic glues in endovascular embolization is manually conducted mainly depending on experience and operation habits of surgeons, the physicochemical effect on the coaxial injection process is not clear yet. In this study, based on the vascular structure of arteriovenous malformations in vivo and their hemodynamic characteristics, a model in vitro to mimic the coaxial injection of embolic glues is designed and constructed according to the operative technique of endovascular embolization in clinic. With the built model, we investigate the influence mechanism of the coupling effect of hemodynamics and polymerization on the droplet formation process during the coaxial injection. Further, under the conditions of both steady and pulsatile blood flow, we probe the quantitative relation between shape and size of droplets formed during the coaxial injection, and the mixing ratio of embolic mixtures, injection flow rate and pipe size. This work not only provides guidance for the selection of mixing ration and the improvement of operative techniques of the coaxial injection in endovascular embolization, but also offers key technological support for the preoperative training and the surgical instrument development of endovascular embolization.

血流动力学与栓塞胶聚合反应的联合作用在动静脉畸形血管介入栓塞治疗同轴注射过程中起着至关重要的作用，此间胶滴生成过程的控制直接决定栓塞手术效果。目前，血管介入栓塞胶同轴注射过程主要依靠医生的临床经验和操作习惯手动完成，同轴注射过程中理化因素的影响尚不明确。本项目基于在体动静脉畸形血管结构及其血流动力学特征，结合临床血管介入栓塞操作技术，设计并构建模拟血管介入栓塞胶同轴注射过程的体外模拟装置；基于建立的模拟装置，研究血流动力学与栓塞胶聚合反应联合作用影响同轴注射胶滴生成过程的机制；探究在定常与脉动血液流动条件下，同轴注射生成胶滴形态、尺寸与栓塞剂混合物成分比例、注射速率、管径尺寸的定量关系；这些研究工作将为临床上选择栓塞剂成分比例及优化改进血管介入栓塞同轴注射操作技术提供指导意见，同时为血管介入栓塞术术前培训及手术仪器设备的研发提供关键技术支撑。

血流动力学与栓塞胶聚合反应的联合作用在动静脉畸形血管介入栓塞治疗同轴注射过程中 起着至关重要的作用，此间胶滴生成过程的控制直接决定栓塞手术效果。目前，血管介入栓塞 胶同轴注射过程主要依靠医生的临床经验和操作习惯手动完成，同轴注射过程中理化因素的影响尚不明确。本项目基于在体动静脉畸形血管结构及其血流动力学特征，结合临床血管介入栓塞操作技术，设计并构建了血管介入栓塞胶同轴注射过程的体外模型及其外围高速影像采集系统；基于建立的体外模拟实验平台，实验研究血流动力学与栓塞胶聚合反应联合作用对同轴注射胶滴生成过程的影响规律；研究了不同血液流动条件下，同轴注射生成胶滴形态、尺寸与栓塞剂混合物成分比例、注射速率的定量关系。实验结果表明通过调节栓塞胶混合比例、注射速率能够有效控制生成胶滴体积、生成时间、避免近端栓塞。这些研究工作不仅为临床上选择栓塞剂成分比例及优化改进血管介入栓塞同轴注射操作技术提供了离体测试评估实验平台，而且为血管介入栓塞术术前培训及手术仪器设备的研发提供一定的线索和依据。